Evidence Table 35. Drug Interventions for KQ 6
Evidence Table 35. Drug Interventions for KQ 6
Author, Year / Arm Name / Drug name / Dose / Route / Frequency / Timing of first dose / Planned duration of therapy (Other e.g.INR) / Concurrent TherapyPharmacological versus PharmacologicalCohort-Prospective
Kothari, S. 20071 / Enoxaparin / Enoxaparin / 40mg / SQ / Twice daily / Pre-op / Hospital stay / Sequential compression devices, early ambulation
Kothari, S. 20071 / Heparin / Heparin / 5000U / SQ / Thrice daily / Pre-op / Hospital stay / Sequential compression devices, early ambulation
Rowan, B. O. 20082 / Group1 / Enoxaparin / 30mg / SQ / 12 hourly / 11pm on op-day / NR / Pneumatic compression devices before anesthesia, early ambulation was encouraged on day of surgery
Rowan, B. O. 20082 / Group2 / Enoxaparin / 40mg / SQ / 12 hourly / 11pm on op-day / NR / Pneumatic compression devices before anesthesia, early ambulation was encouraged on day of surgery
Simone, E. 20083 / 40mg arm / Enoxaparin / 40mg / SQ / 12 hourly / 11pm on op day / Hospital stay / None
Simone, E. 20083 / 60mg arm / Enoxaparin / 60mg / SQ / 12 hourly / 11pm on op day / Hospital stay / None
Cohort-retrospective
Hamad, G.G., 2005 4 / Center A / Enoxaparin / 30mg / SC / NR / NR / Duration not available, / No
Hamad, G.G., 20054 / Center B / Enoxaparin / 30 mg / SC / Q24h / not reported / 10days / No
Hamad, G.G., 20054 / Center C / Enoxaparin / 40 mg / SC / Q24h / not reported / 12-120hrs / No
Hamad, G.G., 20054 / Center D / Enoxaparin / 40 mg / SC / Q24h / not reported / 12-24hrs / No
Hamad, G.G., 20054 / Center E / Enoxaparin / 40 mg / SC / Q12h / not reported / 12-36hours / No
Ojo, P., 20085 / 40mg / Enoxaparin / 40mg / SQ / 12 hourly / 12 hours post-op / 2 weeks post-op / None
Ojo, P., 20085 / 60mg / Enoxaparin / 60mg / SQ / 12 hourly / 12 hours post-op / 2 weeks post-op / None
Cohort-retrospective
Scholten, D. J.,20026 / Group 1 / Enoxaparin / 30mg / SQ / 12 hourly / 2 hours pre-op / Till fully ambulatory or hospital discharge / Graded compression stockings, intermittent pneumatic compression devices or sequential compression devices and early ambulation
Scholten, D. J.,20026 / Group 2 / Enoxaparin / 40mg / SQ / 12 hourly / 2 hours pre-op / Till fully ambulatory or hospital discharge / Graded compression stockings, intermittent pneumatic compression devices or sequential compression devices and early ambulation
Non-randomized Trials
Borkgren-Okonek, M. 20087 / 40mg / Enoxaparin / 40mg / SQ / 12hourly till hospital discharge then once daily / 12 hours post-op / Till 10 days after hospital discharge / Calf-length intermittent pneumatic compression devices, Post-op day or next day mobilization, UFH 5000U within 2hrs before surgery
Non-randomized Trials
Borkgren-Okonek, M. 20087 / 60mg / Enoxaparin / 60mg / SQ / 12hourly till hospital discharge then once daily / 12 hours post-op / Till 10 days after hospital discharge / Calf-length intermittent pneumatic compression devices, Post-op day or next day mobilization, UFH 5000U within 2hrs before surgery
Raftopoulos, I., 20088 / Group A / Enoxaparin / 30mg / SQ / 12 hourly / 1 hour pre-op / Hospital stay / Calf-length pneumatic compression devices
Raftopoulos, I., 20088 / Group B / Enoxaparin / 30mg / SQ / 12hourly / I hour pre-op / Hospital stay and 10 days post hospital discharge / Calf-length pneumatic compression devices
Pharmacological AloneCohort-retrospective
Singh, K., 2011 9 / NR / Enoxaparin / BMI <40: 30mg / SQ / 12 hourly / 1 hour before incision / NR / Pneumatic compression device
Singh, K., 2011 9 / NR / Enoxaparin / BMI 40-49: 40mg / SQ / 12 hourly / 1 hour before incision / NR / Pneumatic compression device
Singh, K., 2011 9 / NR / Enoxaparin / BMI 50-59: 50mg / SQ / 12 hourly / 1 hour before incision / NR / Pneumatic compression device
Singh, K., 2011 9 / NR / Enoxaparin / BMI >50: 60mg / SQ / 12 hourly / 1 hour before incision / NR / Pneumatic compression device
AIS= Abbreviated Injury Scale; BMI= Body Mass Index; CAT= Computed Axial Tomography; CT= Computed Tomography; CTA= Computed Tomography Angiography; CUS= Compression Ultrasonography; DVT= Deep Vein Thrombosis; GCS= Glasgow Coma Scale; Hr(s)= Hour(s); ICU= Intensive Care Unit; IPG= Impedance Phlebography; ISS= Injury Severity Score; IVC= Inferior Vena Cava; IVCF= Inferior Vena Cava Filter; LE= Lower Extremity; LMWH= Low Molecular Weight Heparin; mg= milligram; NIH= National Institutes of Health; NR= Not Reported; PE= Pulmonary Embolism; P-IVCF= Prophylactic Inferior Vena Cava Filter; RCT= Randomized Controlled Trial; R-IVCF= Retrievable
Reference List
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1Kothari SN, Lambert PJ, Mathiason MA. A comparison of thromboembolic and bleeding events following laparoscopic gastric bypass in patients treated with prophylactic regimens of unfractionated heparin or enoxaparin. 2007; 194:709-11.
Notes: Number of Volumes: 6
Record Number: 523
2Rowan BO, Kuhl DA, Lee MD, Tichansky DS, Madan AK. Anti-Xa levels in bariatric surgery patients receiving prophylactic enoxaparin. ObesSurg 2008; 18(2):162-6.
3Simone EP, Madan AK, Tichansky DS, Kuhl DA, Lee MD. Comparison of two low-molecular-weight heparin dosing regimens for patients undergoing laparoscopic bariatric surgery. SurgEndosc 2008; 22(11):2392-5.
4HamadGG, Choban PS. Enoxaparin for thromboprophylaxis in morbidly obese patients undergoing bariatric surgery: findings of the prophylaxis against VTE outcomes in bariatric surgery patients receiving enoxaparin (PROBE) study. ObesSurg 2005; 15(10):1368-74.
5Ojo P, Asiyanbola B, Valin E, Reinhold R. Post discharge prophylactic anticoagulation in gastric bypass patient-how safe? ObesSurg 2008; 18(7):791-6.
6Scholten DJ, HoedemaRM, Scholten SE. A comparison of two different prophylactic dose regimens of low molecular weight heparin in bariatric surgery. ObesSurg 2002; 12(1):19-24.
7Borkgren-OkonekMJ, Hart RW, Pantano JE et al. Enoxaparin thromboprophylaxis in gastric bypass patients: extended duration, dose stratification, and antifactorXa activity. SurgObesRelat Dis 2008; 4(5):625-31.
8Raftopoulos I, Martindale C, Cronin A, Steinberg J. The effect of extended post-discharge chemical thromboprophylaxis on venous thromboembolism rates after bariatric surgery: a prospective comparison trial. SurgEndosc 2008; 22(11):2384-91.
9Singh K, Podolsky ER, Um S et al. Evaluating the Safety and Efficacy of BMI-Based Preoperative Administration of Low-Molecular-Weight Heparin in Morbidly Obese Patients Undergoing Roux-en-Y Gastric Bypass Surgery. ObesSurg 2011.
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